CLINICAL PROFILE AT ADMISSION OF PATIENTS WITH COVID-19 AND FACTORS ASSOCIATED WITH CLINICAL SEVERITY
DOI:
https://doi.org/10.47820/recima21.v5i4.5127Keywords:
COVID-19. Epidemiological Profile. Disease Severity.Abstract
The SARS-CoV-2 virus still maintains heterogeneity in relation to symptoms and clinical evolution. Thus, the objective of this study was to describe the characteristics of the admission of patients diagnosed with COVID-19 in a public hospital, associated with clinical severity. This is a cross-sectional study involving 170 patients hospitalized with COVID-19, from March 2020 to December 2021, allocated into two groups, according to the severity of the disease: moderate group (n=87) and severe group (n=83). The mean age observed in the population was 59.12 years, with a predominance of males (51.2%). The overall death rate of the patients studied was 42.4% (n=72), being 60.2% (n=50/83) vs. 25.3% (n=22/87) among critically ill patients vs. hospitalized for Severe Acute Respiratory Syndrome (SARS). Cardiovascular and infectious abnormalities were associated with patients classified as severe (p<0.05). In the multivariate analysis, patients with SARS were 407% more likely to have greater severity. For each unit of increase in indirect bilirubin and urea, at the time of admission, there was a 274% increase and a 2% increase in the chance of hospitalization in severe condition, respectively. Ultimately, it was found that patients with severe COVID-19 admitted to the ICU had considerable mortality and morbidity and a high incidence of SARS, which may have contributed to the outcome of death.
Downloads
References
Mattei L, Heinen VL. Impacts of the COVID-19 crisis on the Brazilian labor market. Braz J Polit Econ. 2020;40(4):647-68. https://doi.org/10.1590/0101-31572020-3200 DOI: https://doi.org/10.1590/0101-31572020-3200
Ministério da Saúde (BR). Diretrizes para diagnóstico e tratamento da Covid-19. Brasília, DF: MS; 2020.
Raman R, Patel KJ, Ranjan K. COVID-19: Unmasking Emerging SARS-CoV-2 Variants, Vaccines and Therapeutic Strategies. Biomolecules. 2021;11(7):993. https://doi.org/10.3390/biom11070993 DOI: https://doi.org/10.3390/biom11070993
Kumar A, Narayan RK, Prasoon P, Kumari C, Kaur G, Kumar S, et al. Mecanismos del COVID-19 en el cuerpo humano: lo que sabemos hasta ahora. Kompass Neumol. 2022;4:3-20. https://doi.org/10.1159/000521507 DOI: https://doi.org/10.1159/000521507
Aleem A, Akbar Samad AB, Slenker AK. Emerging Variants of SARS-CoV-2 And Novel Therapeutics Against Coronavirus (COVID-19). In: StatPearls. Treasure Island (FL): StatPearls Publishing, 2022. PMID: 34033342
Bonifaz LC, Ontiveros-Padilla LA, López-Macías C. The role of T Cells in SARS-CoV-2 Infection. Rev Med Inst Mex Seguro Soc. 2020;58(Supl 2):S312-315. DOI: 10.24875/rmimss.m20000144. PMID: 34695345.
Chitimus DM, Popescu MR, Voiculescu SE, Panaitescu AM, Pavel B, Zagrean L, et al. Melatonin’s Impact on Antioxidative and Anti-Inflammatory Reprogramming in Homeostasis and Disease. Biomolecules. 2020;10(9):1211. https://doi.org/10.3390/biom10091211 DOI: https://doi.org/10.3390/biom10091211
Chen JM. Novel statistics predict the COVID‐19 pandemic could terminate in 2022. J Med Virol. 2022;94(6):2845–48. Doi: 10.1002/jmv.27661 DOI: https://doi.org/10.1002/jmv.27661
Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. 2020;8(5):475–81. Doi: 10.1016/S2213-2600(20)30079-5 DOI: https://doi.org/10.1016/S2213-2600(20)30079-5
Corrêa TD, Midega TD, Timenetsky KT, Cordioli RL, Barbas CS, Silva M, et al. Clinical characteristics and outcomes of COVID-19 patients admitted to the intensive care unit during the first year of the pandemic in Brazil: a single center retrospective cohort study. Einstein (São Paulo). 2021;19:1-10. https://doi.org/10.31744/einstein_journal/2021ao6739 DOI: https://doi.org/10.31744/einstein_journal/2021AO6739
Tan E, Song J, Deane AM, Plummer MP. Global Impact of Coronavirus Disease 2019 Infection Requiring Admission to the ICU. Chest. 2020;159(2):524-36. https://doi.org/10.1016/j.chest.2020.10.014 DOI: https://doi.org/10.1016/j.chest.2020.10.014
Niquini RP, Lana RM, Pacheco AG, Cruz OG, Coelho FC, Carvalho LM, et al. Description and comparison of demographic characteristics and comorbidities in SARI from COVID-19, SARI from influenza, and the Brazilian general population. Cad. Saúde Pública. 2020;36(7):e00149420. https://doi.org/10.1590/0102-311X00149420 DOI: https://doi.org/10.1590/0102-311x00149420
Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study. Lancet. 2020;395(10229):1054-62. https://doi.org/10.1016/s0140-6736(20)30566-3 DOI: https://doi.org/10.1016/S0140-6736(20)30566-3
Goyal P, Choi JJ, Pinheiro LC, Schenck EJ, Chen R, Jabri A, et al. Clinical Characteristics of Covid-19 in New York City. N Engl J Med. 2020;382(240:2372–74. Doi: 10.1056/NEJMc2010419 DOI: https://doi.org/10.1056/NEJMc2010419
Bruno LC, Soares JAH, Lelis ESDS, Martins RM, Pinto TO, Silva IP, et al. Dímero-D como importante marcador para estratificar a gravidade da infecção pelo novo coronavírus: revisão sistemática da literatura. Hematol Transfus Cell Ther. 2020;42:530–1. Doi:10.1016/j.htct.2020.10.895 DOI: https://doi.org/10.1016/j.htct.2020.10.895
Ministério da Saúde (BR). Ficha de registro individual – casos de síndrome respiratória aguda grave hospitalizado [Internet]. Brasília, DF: MS; [2020] [citado 2023 Jan 14]. Disponível em: https://saude.rs.gov.br/upload/arquivos/carga20190433/05143355-25141516-1-ficha-srag-hospital.pdf
Su Y, Tu G, J M, Yu SJ, Zheng JL, Ma GG, et al. Comparison of CRB-65 and quick sepsis-related organ failure assessment for predicting the need for intensive respiratory or vasopressor support in patients with COVID-19. J Infect. 2020;81(4):647–79. https://doi.org/10.1016/j.jinf.2020.05.007 DOI: https://doi.org/10.1016/j.jinf.2020.05.007
Kamal M, Omirah MA, Hussein A, Saeed H. Assessment and characterisation of post-COVID-19 manifestations. Int J Clin Pract. 2021;75(3):e13746. https://doi.org/10.1111/ijcp.13746 DOI: https://doi.org/10.1111/ijcp.13746
Madahar P, Wunsch H, Jha P, Slutsky AS, Brodie D. Trends in COVID-19-related in-hospital mortality: lessons learned from nationwide samples. Lancet Respir Med. 2021;9(4):322–4. https://doi.org/10.1016/s2213-2600(21)00080-1 DOI: https://doi.org/10.1016/S2213-2600(21)00080-1
Conti P, Younes A. Coronavirus COV-19/SARS-CoV-2 affects women less than men: clinical response to viral infection. J Biol Regul Homeost Agents. 2020;34(2):339-43. Doi: 10.23812/Editorial-Conti-3.
Sansone NM, Valencise FE, Bredariol RF, Peixoto AO, Marson FA. Profile of coronavirus disease enlightened asthma as a protective factor against death: An epidemiology study from Brazil during the pandemic. Front Med. 2022;9. https://doi.org/10.3389/fmed.2022.953084 DOI: https://doi.org/10.3389/fmed.2022.953084
Espinosa OA, Zanetti AD, Antunes EF, Longhi FG, Matos TA, Battaglini PF. Prevalence of comorbidities in patients and mortality cases affected by SARS-CoV2: a systematic review and meta-analysis. Rev Inst Med Trop S Paulo. 2020;62:e43. https://doi.org/10.1590/s1678-9946202062043 DOI: https://doi.org/10.1590/s1678-9946202062043
Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, Qiu Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. 2020;395(10223):507-13. https://doi.org/10.1016/s0140-6736(20)30211-7 DOI: https://doi.org/10.1016/S0140-6736(20)30211-7
Zhou P, Yang XL, Wang XG, Hu B, Zhang L, Zhang W, et al. A pneumonia outbreak associated with a new coronavirus of probable bat origin. Nature. 2020;579(7798):270-3. https://doi.org/10.1038/s41586-020-2012-7 DOI: https://doi.org/10.1038/s41586-020-2012-7
Alam MS, Czajkowsky DM. SARS-CoV-2 infection and oxidative stress: Pathophysiological insight into thrombosis and therapeutic opportunities. Cytokine Growth Factor Rev. 2022;63:44-57. https://doi.org/10.1016/j.cytogfr.2021.11.001 DOI: https://doi.org/10.1016/j.cytogfr.2021.11.001
Yoo J, Grewal P, Hotelling J, Papamanoli A, Cao K, Dhaliwal S, et al. Admission NT‐proBNP and outcomes in patients without history of heart failure hospitalized with COVID‐19. ESC Heart Fail. 2021;8(5):4278-87. https://doi.org/10.1002/ehf2.13548 DOI: https://doi.org/10.1002/ehf2.13548
Monteiro IC, Prudente AL, Carneiro JF, Gomes JM, Mariano HM, Silvério AD. Manifestações hepáticas em pacientes com covid‐19: uma revisão integrativa. Braz J Infect Dis. 2021;25:101138. https://doi.org/10.1016/j.bjid.2020.101138 DOI: https://doi.org/10.1016/j.bjid.2020.101138
Zeng F, Huang Y, Guo Y, Yin M, Chen X, Xiao L, et al. Association of inflammatory markers with the severity of COVID-19: A meta-analysis. Int J Infect Dis. 2020;96:467–74. Doi:10.1016/j.ijid.2020.05.055 DOI: https://doi.org/10.1016/j.ijid.2020.05.055
Downloads
Published
License
Copyright (c) 2024 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
This work is licensed under a Creative Commons Attribution 4.0 International License.
Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.
